Department of Otolaryngology-Head & Neck Surgery and Medical Laser Research Center, Dankook University College of Medicine, Cheonan, Korea.
Laryngoscope. 2009 Sep;119(9):1781-7. doi: 10.1002/lary.20568.
OBJECTIVES/HYPOTHESIS: The aim of this study was to evaluate the antibacterial effects of photodynamic therapy (PDT) on common bacteria causing otitis media with effusion (OME).
An in vitro study was carried out using a hematoporphyrin derivative sensitizer (Photogem; Lemonosov Institute of Fine Chemical, Moscow, Russia) and a 632-nm diode laser on Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae. The presence of colony-forming units of the bacteria was examined, the microscopic structures of the bacteria were examined by transmission electron microscopy (TEM), and flow cytometry of the bacteria was performed. An in vivo PDT study was performed using gerbils. S. pneumoniae or H. influenzae were injected into bullae. The Photogem was injected into the bullae 2 days later when OME developed, and transcanal irradiation with the 632-nm diode laser (90 J) was performed. Middle ear and bulla were washed with Dulbecco's phosphate buffered saline (DPBS) and the washed DPBS was cultured. The presence of bacterial colonies was examined.
The PDT was effective in killing all three kinds of bacteria. TEM showed damaged bacterial cell membranes and cytoplasmic structures, and the flow cytometry showed a lower number of viable bacteria in the PDT group compared to the control group. PDT was effective in killing S. pneumoniae in 87% of the infected bullae with OME, whereas it was effective in eradicating H. influenzae in 50% of the infected bullae with OME.
The results of these studies demonstrated that PDT may be effective to treat otitis media. PDT may have clinical implications in the treatment of otitis media that is resistant to antibiotic therapy.
目的/假设：本研究旨在评估光动力疗法（PDT）对引起分泌性中耳炎（OME）的常见细菌的抗菌作用。
采用血卟啉衍生物敏化剂（Photogem；俄罗斯莫斯科 Lemonosov 精细化学研究所）和 632nm 二极管激光对流感嗜血杆菌、卡他莫拉菌和肺炎链球菌进行体外研究。检查细菌的菌落形成单位，通过透射电子显微镜（TEM）检查细菌的微观结构，并对细菌进行流式细胞术检测。使用沙鼠进行体内 PDT 研究。将肺炎链球菌或流感嗜血杆菌注入中耳鼓室。当出现 OME 时，将 Photogem 注入鼓室 2 天后，用 632nm 二极管激光（90J）进行经耳道照射。用 Dulbecco 磷酸盐缓冲盐水（DPBS）冲洗中耳和鼓室，培养冲洗的 DPBS。检查细菌菌落的存在。
PDT 能有效杀灭这三种细菌。TEM 显示细菌细胞膜和细胞质结构受损，流式细胞术显示 PDT 组的活菌数低于对照组。PDT 对 87%的伴有 OME 的感染鼓室中的肺炎链球菌有效，而对 50%的伴有 OME 的感染鼓室中的流感嗜血杆菌有效。
这些研究的结果表明，PDT 可能是治疗中耳炎的有效方法。PDT 在治疗对抗生素治疗有抗药性的中耳炎方面可能具有临床意义。
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